Local MP speaks in a Westminster Hall debate on health funding inequalities.Last week, local Member of Parliament, Jeremy Hunt continued his campaign against local health cuts. He spoke at a Westminister Hall debate on Community Hospitals, raising the issue of the inequality of Primary Care Trust Funding. (See Hansard extract below).Jeremy, together with Guildford MP, Anne Milton has set up a cross community joint campaign group to prevent any damaging health cuts across the Guildford and Waverley Primary Care Trust area. The first meeting of the group is this Friday 11th November. Westminster HallWednesday 2 November 2005[Mr. Roger Gale in the Chair]Community HospitalsMr. Jeremy Hunt (South-West Surrey) (Con): I shall talk about health inequalities, as they go to heart of the debate. There are two different concepts of health inequality. The first is when one primary care trust receives less per head than another. The second is when two PCTs receive broadly the same amount, after weighting, but choose to spend their allocation differently. One PCT might spend more money on prescription drugs, another might spend more on acute care, and yet another more on community hospitals. One PCT might use its resources more efficiently than another. David Taylor : Will the hon. Gentleman give way? Mr. Hunt : May I develop the thrust of my argument, because I want to base my contribution on the Secretary of State said last week? In what essence, the Government are saying that that the problems in community hospitals are caused by the second type of inequality; that differing local priorities or poor financial management are the culprits. I contend that the problem is the first type of inequality, in that PCTs in certain parts of the country do not receive the amount that they need to deliver expected levels of health care because of fundamental flaws in the weighting formula that allocates funds to different areas. David Taylor : I should point out that there are more complex and sophisticated reasons for differences in the per capita funding of PCTs, not least age, profile, morbidity and other social statistics. Does the hon. Gentleman accept that an ideal system will not necessarily deliver comparable amounts per head even to adjacent PCTs? Mr. Hunt : I accept the hon. Gentleman's point. Let me explain why I believe there to be a problem in the weighting formula. Guildford and Waverley PCT serves one of the most affluent parts of the country, and I fully accept that people there are relatively healthier, but against that must be weighed the fact that it is one of the most expensive areas of the country in which to deliver health care and it also has a much higher proportion of elderly people. Guildford and Waverley PCT has received generous increases in spending. The spending for our area increased by 9 per cent. last year, and is due to increase by 8 per cent. this year—increases of £18 million and 2 Nov 2005 : Column 272WH £19 million respectively. Despite that, it is in crisis. Cranleigh hospital, which is the community hospital in the constituency of my hon. Friend the Member for Guildford (Anne Milton), faces closure. The number of beds is being cut back in Haslemere and Farnham community hospitals. A specialist rehabilitation centre, Milford, which has an enormously long track record of helping elderly people from the area make a complete recovery after strokes, also faces closure. The PCT is currently closing one-third of the community beds as an emergency measure, despite the fact that that flies in the face of the agreed local NHS strategy. What is going wrong? The PCT has apparently been overspending and it is being asked to reign in that spending. However, considering the funding allocations, it is spending 9 per cent. less than the national average, despite the higher cost of delivering health care in the area, but the funding formula after the weighting states that it is still spending too much. This year it is spending £16.3 million more than it should be, but the weighting formula states that it should be spending 17 per cent. less than the national average. Let us be clear: according to the formula, the Department of Health expects one of the most expensive areas of the country for delivering health care, with a much higher proportion of elderly people than average, to deliver that health care spending about a fifth less money than the national average per head. Why is that? It is simply because the weighting formula states that people in the Guildford and Waverley PCT area are healthier than those in other parts of the country and therefore it needs less money. However, the effect of such a huge disparity in funding is not to decrease health inequalities but to increase them. For example, waiting times for ENT surgery is up to 13 weeks in Manchester but up to 26 weeks in Surrey; people have to wait up to 15 weeks for breast surgery in Leicester but up to 24 weeks in Surrey; for trauma and orthopaedics in Sedgefield, to take a random example, people have to wait up to 13 weeks, but in Surrey they have to wait up to 36 weeks. In trying to eradicate health inequalities, the weighting formula needs to consider not only health outcomes, such as mortality rates, but access to health care. If it focuses only on health outcomes it ends up creating equality, but by punishing the most vulnerable people who happen to live in more prosperous areas by making it massively harder for them to access health care. I say to the Minister that it is very easy to look at areas such as Surrey and paint them in one's mind as a uniformly prosperous place, but nothing could be further from the truth. Although the proportion of socially deprived people in such areas may be lower, those that are disadvantaged are often far more vulnerable than those in areas with widespread deprivation because they do not have access to many of the grants and funds targeted at more deprived areas. When waiting times are increased and access to community beds is decreased, wherever it is, the people who suffer the most are those who have the least and they are the ones who will suffer if the funding formula is not changed. 2 Nov 2005 : Column 273WH The Minister and I both support a well-funded and fair health service, and in that spirit I ask her to recognise that many of the problems we are discussing are caused by a flaw in how funds are allocated. Of course, we need to take account of social deprivation, but we also need to take proper account of the cost of delivering health care and to promote fairness in access to health services. Sometimes mathematical formulae are designed to balance conflicting objectives fairly but they can also have perverse consequences, which is what is happening now. 10.24 am